Usefulness of Sonohysterography in Differentiating Endometrial Cancer from endometrial Hyperplasia

Abstract

PURPOSE: To characterize the sonohysterographic(SH) findings of endometrial hyperplasia and cancer and to deter-mine the role of SH in differentiating endometrial cancer from hyperplasia. MATERIALS and METHODS:The clinical, pathologic and SH findings of 38 patients with histologically confirmed en-dometrial hyperplasia(n=21), atypical hyperplasia(n=6), and cancer(n=11) were reviewed retrospectively. We e-valuated the presence and morphologic characteristics(surface contour echogenicity, echotexture) of endometrial thickening and mass, obliteration of endometrial cavity, and disruption of endometrial-myometrial interface on SH . RESULTS : SH findings of endometrial hyperplasia were endometrial thickening in 17 cases(81%), mass in 8 cas-es( 38%), and regular surface of endometrium and mass in 16(76%) and 6 cases(75%) respectively. Atypical hy-perplasia showed endometrial thickening in 4 cases(67%), mass in 2 cases(33%), and regular surface of en-dometrium and mass in 4(67%) and 1 case(50%) respectively. Obliteration of endometrial cavity was seen only in 3 cases(14%) of endometrial hyperplasia and 1 case(17%) of atypical hyperplasia and disruption of endome-trial- myometrial interface was not seen. Endometrial cancer showed endometrial thickening in 6 cases(55%), mass in 7 cases(64%), irregular surface of endometrium and mass in 10(91%) and 7 cases(100%) respectively, obliteration of endometrial cavity in 10 cases(91%), and disruption of endometrial-myometrial interface in 4 of 8 cases with myometrial invasion. Using endometrial thickening or mass with irregular surface and obliteration of endometrial cavity as the positive findings for SH diagnosis of endometrial cancer, we observed sensitivity of 90.9%, specificity of 85.2%, and accuracy of 86.8%. CONCLUSION : The demonstration of the irregular surface with endometrial thickening or mass and obliteration of endometrial cavity through SH were suggestive of endometrial cancer. SH could be useful in the diagnosis and